Abstract: PO1390
Shrunken Pore Syndrome: Prevalence and Association with Mortality in a Population-Based Cohort of Elderly Women
Session Information
- Geriatric Nephrology: New Insights
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Geriatric Nephrology
- 1100 Geriatric Nephrology
Authors
- Malmgren, Linnea, Lunds Universitet, Lund, Sweden
- Mcguigan, Fiona, Lunds Universitet, Lund, Sweden
- Christensson, Anders, Lunds Universitet, Lund, Sweden
- Åkesson, Kristina, Lunds Universitet, Lund, Sweden
Background
Decreased kidney function results in lower clearance and increased plasma concentration of a GFR marker. So far creatinine has been the commonly used GFR marker but cystatin C becomes more common. Shrunken pore syndrome (SPS) is a recently identified kidney syndrome characterized by disturbed filtration of mid-sized molecules (5-30 kDa) compared to smaller ones (<0.9 kDa) (Fig1). Resulting in increased plasma levels of cystatin C (cysC) compared to creatinine. SPS is associated with increased risk of cardiovascular disease (CVD) and increased mortality risk. So far few data are available about SPS in population-based cohorts.
Methods
75-yr old women (n=849) from the population-based Osteoporosis Prospective Risk Assessment (OPRA-) cohort, with follow-up after 5yr and 10yr were studied. eGFR was calculated with the CKD-EPI equation. SPS was defined as eGFRcysC/eGFRcrea ratio <0.6 and mortality risk (HR [95% CI]) estimated. Women with sarcopenia or on glucocorticoids were excluded.
Results
Almost 1 in 10 women (9%) had SPS at age 75 but at age 80 the majority of these women had increased their eGFRcysC/eGFRcrea ratio >0.6 (range from 0.6-1.0). Women with SPS had higher 10-yr mortality risk compared with ratios >0.9 (HRadj 1.7 [95% CI, 1.1-2.6]). Table 1.
Conclusion
SPS defined as eGFRcysC/eGFRcrea ratio <0.6 is common in elderly women and associated with increased mortality. While longitudinal data indicate that the state may be reversible. Our results also confirm other studies and suggest that SPS may be a clinically applicable tool to assess mortality risk in the elderly.
SPS (eGFRcysC/eGFRcrea ratio <0.6) is associated with increased 10-yr mortality
eGFRcysC/eGFRcrea Ratio (age 75) | |||||
n=366 ≥0.9 | n=178 0.8-0.89 | n=140 0.7-0.79 | n=85 0.6-0.69 | n=80 <0.6 | |
Model 1* | 1 (ref) | 1.0 [0.7-1.4] | 1.0 [0.6-1.4] | 1.3 [0.8-2.0] | 1.7 [1.1-2.6]** |
*Adjusted for: diabetes, high blood pressure, CVD, smoking. **p=0.016
Possible pathophysiological mechanisms of SPS (1) reduced pore size and (2) thickening of the glomerular basement membrane
Funding
- Private Foundation Support